Heart pacer

ABSTRACT

A heart pacer to be implanted between the pectoralis major muscle and the skin a short distance below the clavicle having an outer container in the shape of an ovaloid.[...]. .Iadd.being, except where the heart lead is connected, curved in all dimensions and free of corners and shape ends. .Iaddend.Such a heart pacer adapts itself positionally, cosmetically and with a minimum of discomfort to implantation.

REFERENCE TO RELATED APPLICATIONS

This application is a continuation-in-part of application Ser. No.378,636 filed July 12, 1973, now U.S. Pat. No. 3,866,616 granted Feb.18, 1975 to David L. Purdy, George J. Magovern and Nicholas P. D. Smythfor Heart Pacer and assigned to CORATOMIC INC.

BACKGROUND OF THE INVENTION

This invention relates to heart pacers and has particular relationshipto heart pacers which are implanted in human beings. It has become thepractice to implant such heart pacers in the chest, usually on the left,a short distance below the clavicle or collar bone. The pacer soinstalled rests between the pectoralis major muscle and the skinengaging the skin outwardly of this muscle. Typically the conductor fromthe pacer which supplies the pulsations is passed upwardly over theclavicle and is connected to the heart through a vein adjacent theclavicle.

In accordance with the teachings of the prior art the outer container ofthe pacer has the form of a rectangular parallelapiped with roundedcorners. Such a pacer does not fit into the biological contour of thebody where it is installed and is subject to expulsion. In addition, theedges of the pacer container produce an unsightly protrusion of the skinand the engagement of these edges and the corners with the skin causesdiscomfort and tends to cause skin necrosis.

It is an object of this invention to overcome the above-describeddifficulties and disadvantages of the prior art and to provide a heartpacer to be implanted in the chest of a human being that shall fit intothe biological contour of the body where it is implanted and shall bereadily acceptable by the body, shall be cosmetic, shall not have atendency to cause skin necrosis and shall be readily implantable in awide variety of sites in the body.

SUMMARY OF THE INVENTION

In accordance with this invention a heart pacer is provided which has anouter container .Iadd.or casing .Iaddend.of generally ovaloid form..Iadd.Except where the heart lead is connected, this container is curvedin all dimensions so as to be free of corners and sharp ends..Iaddend.This pacer seats neatly in the pectoralis major muscleminimizing any tendency for the muscle to expel the pacer. The skinadapts itself readily to this pacer minimizing unsightly protrusions.The pacer has no edges or ends which engage the skin and tend to causeskin necrosis.

BRIEF DESCRIPTION OF THE DRAWINGS

For a better understanding of this invention, both as to itsorganization and so to its method of operation, together with additionalobjects and advantages thereof, reference is made to the followingdescription, taken in connection with the accompanying drawings, inwhich:

FIG. 1 is a view in side elevation, with a part of the wall broken away,of a heart pacer in accordance with this invention;

FIG. 2 is a view in end elevation as seen from the direction of thearrow II of the pacer shown in FIG. 1;

FIG. 3 is a view in end elevation from the direction of the arrow III ofthe pacer shown in FIG. 1;

FIG. 4 is a plan view from the direction of the arrow IV of the pacershown in FIG. 1;

FIG. 5 is a plan view from the direction of the arrow V of the pacershown in FIG. 1;

FIG. 6 is a fragmental view in section of a part of a human body showingthe manner in which the heart pacer according to this invention isimplanted; and

FIG. 7 is a like fragmental view in section of the human body showingthe manner in which a pacer in accordance with the prior art isimplanted.

DETAILED DESCRIPTION OF THE INVENTION

The apparatus shown in FIGS. 1 through 5 is a heart pacer 11 including agenerally ovaloid container 12 whose contours viewed in differentdirections or sections (FIGS. 2 and 3 parent patent 2,866,616) are ofelliptical form. The container has a head 13 encased in transparentresin (epoxy) from which a catheter 15 (FIG. 6) extends. .Iadd.Thiscontainer 12 except for the head 13 where the catheter 15 enters isthree-dimensional curved (FIGS. 1 through 5) and free of corners andsharp ends. .Iaddend.The catheter 15 is connected to a terminal block17. Within the container there is a power supply 19 and an electricalcircuit 21 for deriving pulsations from the supply 19. The pulsationsare supplied to the heart through the catheter. The power-supply 19 andthe other components are shown in detail in the parent U.S. Pat. No.2,866,616.

Typically, the heart pacer 11 has an overall length of 2.45 inches, awidth of 1.88 inches and a depth of 0.80 inch.

In FIGS. 6 and 7 there are shown some of the members of the human bodyin which a pacer is implanted. The section is taken along the bodybetween the head above and the feet below. The members include the ribs22 between which the intercostal muscle 23 extends. Outwardly of theribs 22 are the pectoralis minor muscle 25 and the pectoralis majormuscle 27. The pectoralis major muscle 27 extends from the clavicle orcollar bone 29. The skin 31 extends outwardly of the pectoralis majormuscle 27 and the clavicle 29.

The pacer 11 according to this invention is implanted with its .Iadd.one.Iaddend.side 33 .Iadd.defining its depth dimension .Iaddend.engaging,and neatly seated on, the pectoralis major muscle 27 and the oppositeside 35 .Iadd.defining its depth dimension .Iaddend.engaging the skin31. The pacer fits neatly against the skin 31 and does not produce anunsightly bulge. The catheter 15 is passed over the clavicle 29, isprovided with a loop 37 above the clavicle 29 and then is passed througha vein (not shown) to the heart.

On the contrary the prior-art pacer 41 (FIG. 7) does not seat on thepectoralis major muscle 27 but engages it at isolated points 43. Theskin 31 engages this pacer 41 along its edges 45 and, because thedeformation of the skin 31 is sharp as shown at 47 rather than gradualas for the pacer according to this invention, an unsightly.[.protrusio.]. .Iadd.protrusion .Iaddend.is produced.

While a preferred embodiment of this invention has been disclosedherein, many modifications thereof are feasible. This invention is notto be restricted except insofar as is necessitated by the spirit of theprior art.

We claim:
 1. A heart pacer including a container having thereinpower-supply means and means for deriving pulsations to be supplied tothe heart from said power-supply means, said container to be implanted ashort distance below the clavicle of the human body, said containerhaving the form generally of an ovaloid its contour as viewed from itsends, its top and bottom and its sides, being of generally oval 0configuration whereby said pacer adapts itself positionally andcosmetically and with a minimum of discomfort to the region of the humanbody where it is implanted.
 2. The heart pacer of claim 1 wherein thecontour of the container as viewed in the directions of its ends, of itstop and bottom and of its sides is of generally ellipticalconfiguration.
 3. The heart pacer of claim 1 to be implanted between thepectoralis major muscle and the epidermis of the host, the dimensions inconnection with the ovaloid contour of the container of the pacer beingsuch that said container seats neatly in the pectoralis major muscle andin the epidermis without producing an unsightly bulge of the epidermis.4. The heart pacer of claim 1 having a container which has substantiallyno sharp corners in the region where it is seated in the body.
 5. Theheart pacer of claim 1 having a terminal for connecting a catheter, saidterminal extending generally tangentially from a surface of thecontainer. .Iadd.
 6. A heart pacer to be implanted in a body by beingseated between the skin and other tissue of said body, said heart pacerincluding a container having therein power-supply means and means forderiving pulsations for the heart from said power-supply means, saidcontainer having a head through which a catheter is to be connected tothe heart extends, said head being encased in a casing forming a part ofsaid container, said container having an outer surface which, except forsaid head and casing, is curved in all dimensions and the transitionfrom each dimension to others is smooth, such that the container is freeof corners and sharp ends, so that when said heart pacer is implanted,it is neatly seated between said other tissue and said skin, the depthof said container being small compared to the length or the width ofsaid container, the said depth being the largest distance between thewall of the container, which is to engage the skin of the host onimplantation, and the opposite wall of said container. .Iaddend. .Iadd.7. The heart pacer of claim 6 wherein the head extends and the catheterenters the head laterally of the wall of the container which is toengage the skin of the host on implantation and the opposite wall of thecontainer. .Iaddend.